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WAKE UP TO THE FACTS ON

Q FEVER

What Is Q Fever?

Q fever is an illness caused by a bacterium called Coxiella burnetii.  The bacterium is transmitted to humans by direct and indirect contact with infected animals, animal products or contaminated material.  It is mainly spread from animals to humans via inhalation of infected particles in the air.

Coxiella burnetii can infect both wild and domestic animals, and their ticks.  Cattle, sheep and goats are the main sources of human infection, but certain wildlife (e.g. kangaroos), feral and domestic animals (e.g. camels, cats and dogs), may also be implicated.

The illness in humans is usually flu-like, but may sometimes have serious and long-lasting consequences.

In Australia, any case of Q fever needs to be reported to health authorities.

WHO IS AT RISK?

People at increased risk of contracting Q fever include those in direct contact or in close proximity to infected animals, their products (such as faeces, urine, milk, wool & especially products of conception) and contaminated material (such as dust, aerosols, soil, grass, straw, clothes).

People working with cattle, sheep, goats and their products (main sources of infection).

e.g. farmers, abattoir/meat workers, shepherds, animal transporters, stockyard workers, dairy farmers & producers, shearers & sorters, tanning/hide workers, vets & veterinary staff, agricultural staff.

People working with wildlife
(e.g. kangaroos), feral or domestic animals
(e.g. camels, cats and dogs) and their products.

e.g. dog & cat breeders, wildlife & zoo workers, handlers, workers culling & processing kangaroos, vets & veterinary staff.

People who live, work or visit at-risk environments or areas in close proximity to them.

e.g. farms, saleyards, livestock transport routes.

People working with C. burnetii or laboratory animals.

e.g. laboratory personnel handling veterinary specimens.

Further information is available from your doctor or state work health and safety guidelines if you work in an occupation considered to be at risk.

WHAT ARE THE SYMPTOMS?

Following infection by Coxiella burnetii, at least 50% of people show no symptoms.1,2 However, some people experience ‘acute’ symptoms that are often described as being similar to having the ‘flu’.

In total, up to 1 in 5 people with ‘acute’ symptoms may develop post Q fever fatigue syndrome or chronic Q fever which can have incapacitating, long-lasting and serious consequences.1,3

In Australia, any case of Q fever needs to be reported to health authorities. Please see your doctor if you think you have symptoms of Q fever.

ACUTE Q FEVER

Acute Q fever symptoms may include:

  • Fever that starts abruptly and can last several weeks
  • Chills
  • Sweating
  • Severe headache
  • Aching muscles and joints
  • Extreme tiredness and confusion
  • Nausea and diarrhoea
  • Blurred vision or extreme sensitivity to light
  • Weight loss
  • Rash

Typical symptoms of acute Q fever appear 2-4 weeks after infection and in most cases self-resolve. Symptoms can last up to 3-6 weeks.

1. ATAGI. The Australian immunisation handbook. 10th ed. Canberra: 2017 [cited 11 August 2017]. www.immunise.health.gov.au/internet/immunise/ publishing.nsf/Content/Handbook10-home 2. Marmion B. A guide to Q fever and Q fever vaccination. CSL Biotherapies. 2009. 3. Wielders CCH et al. Eur J Clin Invest. 2013;43(6):616-39.

CHRONIC Q FEVER

Chronic Q fever is a serious and long-lasting disease and occurs in up to 5% of acute Q fever patients.3  It results from persistent infection in one or more anatomical sites.  It may develop months or even years after the initial episode of Q fever, even in patients that did not have any symptoms to start with and may take years to resolve. A common manifestation of chronic Q fever infection is inflammation of the heart (endocarditis), which more commonly develops in people with certain heart problems. However, individuals may also suffer from persistent infections occurring in the liver, bones and other organs.

POST Q FEVER FATIGUE SYNDROME

Some patients with acute Q fever – up to about 15% – will go on to experience a post-Q fever fatigue syndrome, where symptoms continue to persist for more than 12 months after symptoms first appear.1,2 Symptoms associated with post-Q fever fatigue syndrome (extreme tiredness and other symptoms), can last for years and have the potential to be highly incapacitating.

Q FEVER IS MAINLY SPREAD FROM ANIMALS TO HUMANS VIA INHALATION OF INFECTED PARTICLES IN THE AIR.

HOW DOES Q FEVER SPREAD?

Q fever is mainly spread from animals to humans via inhalation of infected particles in the air.  Other routes of infection include:

  • direct contact with infected animals,
  • contact with infected animal products such as birth products (placenta), milk, urine, faeces, wool and hides,
  • and contact with contaminated material such as soil, grass, straw, and clothes.

Cattle, sheep and goats are the main sources of human infection, but certain native and feral mammals (e.g. kangaroos, bandicoots, rats, horses, camels), as well as domestic animals such as cats and dogs, may also be implicated.

Most infected animals do not show symptoms or get sick. They can shed the bacteria in their urine, faeces, milk, wool and birth products which can subsequently contaminate surrounding material such as aerosols, soil, dust, grass, straw, clothes, hair.  The bacterium is highly infective and resistant, capable of withstanding harsh conditions for long periods of time.

HOW CAN YOU HELP
PREVENT Q FEVER?

It is important to implement control measures to minimise the spread of Coxiella burnetii from infected animals to humans.

Preventative measures for Q fever include:

Vaccination can help prevent Q fever infection and may be recommended for those who are at risk and are appropriate candidates for vaccination.

Washing hands and arms thoroughly in soapy water after handling animals or carcasses.
Washing animal body fluids from the work site and equipment.
Keeping yard facilities for sheep and cattle well away from domestic living areas.
Properly disposing of animal tissues including birthing products.
Minimising dust and rodents in slaughter and animal housing areas.
Removing protective and/or other clothing that may carry the bacteria before returning to the home environment.
Limiting access to high risk facilities for those not vaccinated.
When working in at-risk environments, wearing disposable face masks that are properly fitted (P2/N95 masks) to help filter small air particles and reduce the risk of airborne transmission of Q fever.
For further information refer to the Q fever section in your state government Work Health and Safety guidelines or speak to your doctor.

Information on this website is sourced from:

  • ATAGI. The Australian immunisation handbook. 10th ed. Canberra: 2017 [cited 11 August 2017] www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home
  • Marmion B. A guide to Q fever and Q fever vaccination. CSL Biotherapies. 2009.
  • Parker et al. Lancet. 2006;367(9511):679-88.
  • Wielders CCH et al. Eur J Clin Invest. 2013;43(6):616-39.
  • Palmer et al. Aust N Z J Public Health. 2007; 31(4):330-2.
  • SafeWork NSW. Q fever; [cited 9 Nov 2017]. www.safework.nsw.gov.au/health-and-safety/safety-topics-a-z/diseases/q-fever
  • Worksafe Victoria. Q fever prevention; [cited 12 Nov 2017]. www.worksafe.vic.gov.au/pages/forms-and-publications/forms-and-publications/q-fever-prevention
  • Worksafe QLD. Q fever; [Updated 23 April 2017; cited 12 Nov 2017]. www.worksafe.qld.gov.au/agriculture/workplace-hazards/diseases-from-animals/q-fever
  • Gunaratnam P et al. Aust Fam Physician. 2014;43(3):124-8.
  • Morroy G, et al. PLoS ONE 2016; 11(5): e0155884.
  • Angelakis E et al. Iranian J Publ Health. 2011;40(3):1-18.
  • Queensland Health. Q Fever, Queensland Health Guidelines for Public Health Units; [version 1.0; November 2010; cited 10 May 2017]. www.health.qld.gov.au/cdcg/index/qfever
  • NSW Government. Q fever vaccination fact sheet; [Updated 24 Jan 2018; cited 16 Mar 2018]. www.health.nsw.gov.au/Infectious/factsheets/Pages/q-fever-vaccine.aspx
  • NSW Government. Q fever prevention – how to fit a P2 mask; [cited 5 May 2018]. health.nsw.gov.au/qfever
  • NSW Government. Q fever fact sheet; [cited 5 May 2018]. health.nsw.gov.au/qfever

SEQ/QVAX/0218/0039, Date prepared May 2018.

VACCINATION CAN ALSO HELP PREVENT Q FEVER INFECTION, AND
MAY BE RECOMMENDED FOR THOSE AT RISK, WHO ARE ELIGIBLE
FOR VACCINATION.
FOR MORE INFORMATION ON
Q FEVER AND WAYS TO HELP PROTECT AGAINST
Q FEVER, PLEASE SPEAK TO YOUR DOCTOR.